CAREATC - ANDES CANDIES NPI 1871049486

NPI Information

NPI: 1871049486
Provider Name: CAREATC - ANDES CANDIES
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 52D2086322

Address:
1400 E. EISCONSIN
DELAVAN, WI
ZIP 53115
Phone: (918) 779-7416
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CAREATC - ANDES CANDIES is a primary care clinic center in Delavan, WI. CAREATC - ANDES CANDIES NPI is 1871049486. The provider is registered as an organization entity type.

The provider's business location address is:

1400 E. EISCONSIN
DELAVAN, WI
ZIP 53115
Phone: (918) 779-7416
Fax: (855) 346-7414

The provider's authorized official is Keith Gucwa .
The authorized official title is Director Of Purchasing And Faciliti and has the following contact phone number (918) 779-7416.

The CLIA number assigned to this NPI record is 52D2086322 - other - health center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/1/2016 and was last updated on 9/1/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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